高血圧性脳内出血におけるCT所見とその転帰:-死亡例を中心として-

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Fifty one cases of hypertensive intracerebral hematoma were examined by CT scanner. Thirty four cases were treated surgically. Fifty one cases consisted of putaminal hemorrhage (21 cases), thalamic hemorrhage (12 cases), hemorrhage in the head of caudate (3 cases), hemorrhage in the cauda of caudate (1 case), subcortical hemorrhage (7 cases), pontine hemorrhage (4 cases) and cerebellar hemorrhage (3 cases). (table 1) Extension of putaminal and thalamic hemorrhage were classified into 3 types respectively. Type 1: Hemorrhage localized in the putamen or thalamus. Type 2: Hemorrhage with the partial extension to the internal capsule. Type 3: Hemorrhage with almost the total destruction of the internal capsule. Out of 21 putaminal hemorrhages, 12 cases died. Dead cases consisted of 7 cases of type 2 and 5 cases of type 3. Nine alive cases consisted of 4 cases of type 1 and 5 cases of type 2. Concerning type 2, alive cases had no hematoma casting in the ventricles but 4 out of 7 dead cases were accompanied by hematoma casting. (table 2) If the maximum diameter of the high density area exceeds more than about 15 mm in the computerized tomogram, putaminal hemorrhage is liable to extend to the internal capsule or to rupture into the ventricles. In all eleven dead cases of thalamic hemorrhages, large intraventricular hematoma were found. One alive case belonged to type 1. (tables 3 and 4) There were three cerebellar hemorrhages, two of them were treated surgically. All of them survived with good results.
The Japanese Society on Surgery for Cerebral Strokeの論文

高血圧性脳内出血におけるCT所見とその転帰:-死亡例を中心として-

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